Onkológia 3/2016

Place of bosutinib in the therapy of chronic myeloid leukemia

Although clinical outcomes are favorable in patients with Philadelphia chromosome (Ph) positive CML who receive first-line tyrosine kinase inhibitor (TKI) therapy with imatinib, dasatinib, and nilotinib, disease progression or relapse may occur. Thus, effective second-line agents are crucial. Bosutinib is a second-generation TKI approved for the treatment of patients with Ph+ chronic, accelerated, or blast phase CML who are intolerant or resistant to other TKIs. Clinical trials demonstrated bosutinib’s efficacy in inducing durable hematologic and cytogenetic responses, as well as high rates of progression-free and overall survival, in patients with CML who had developed resistance or intolerance to other TKIs. However, bosutinib was not found to be superior to imatinib for inducing cytogenetic responses in cases of newly diagnosed CML and is thus not indicated for use in TKI-naive patients. The pharmacology, pharmacokinetics, efficacy, and safety of the TKI bosutinib in the management of CML are reviewed.

Keywords: chronic myeloid leukemia, bosutinib, tyrosine kinase inhibitors